cs.CLAug 19, 2026

Pedagogical AI in Mental Health: A Tri-Stream Fine-Tuned LLM Framework for Automated Clinical Supervision and Risk Triage

Authors: Shreeya Sharma, Ravish Gupta, Saket Kumar, Abhishek Aggarwal

Organizations: Senior Software Engineer, Microsoft · Lead Software Engineer, BigCommerce, IEEE Senior Member · University at Buffalo, The State University of New York, Buffalo, NY, USA · Senior Software Engineer, Amazon

Abstract

Modern mental healthcare faces a critical shortage of senior supervisory oversight, leading to a "supervision gap" where novice therapists manage high-stakes risks with delayed professional feedback. This paper proposes a new framework utilizing a fine-tuned Mistral-7B-instruct model as an automated "Supervisor-in-the-Loop" system. By leveraging 106 sessions from the DAIC-WOZ dataset, the model performs a tri-stream analysis: (1) Therapeutic Alliance tracking via semantic adherence, (2) Latent risk prediction using attention-weighted analytics, and (3) Supervisory Triage via a Dynamic Clinical Urgency Index (D-CUI). Our multi-modal VAL (Visual-Acoustic-Linguistic) framework achieves 95% technique identification accuracy [95% CI: 75.1%-99.9%], alliance assessment MAE of 0.105 on a 5-point scale [95% CI: 0.059-0.151], therapeutic fidelity alpha = 0.423, and mean D-CUI of 0.370 [95% CI: 0.322-0.419]. Training converged in 105 steps with 85.2% loss reduction on a single Tesla T4 GPU. The system reduces supervisory triage latency from 72 hours to real time (~10 seconds per session), enabling proactive intervention in high-risk cases. The system addresses the cold-start problem through Bayesian priors and implements timestamp-based modality synchronization for robust multi-modal fusion.

Figures & tables

Explore similar work

CardsList
  1. Assessing Risks of Large Language Models in Mental Health Support: A Framework for Automated Clinical AI Red Teaming

    Feb 23, 2026Ian Steenstra, Paola Pedrelli, Weiyan Shi +2LLM Safety EvaluationClinical Language Model Evaluation

  2. Training Therapeutic Judges and Multi-Agent Systems for Human-Aligned Mental Health Support

    Jun 29, 2026Mizanur Rahman, Abeer Badawi, Elahe Rahimi +4Mental Health CounselingMulti-Agent LLM Systems

  3. Measuring What Matters!! Assessing Therapeutic Principles in Mental-Health Conversation

    Apr 7, 2026Abdullah Mazhar, Het Riteshkumar Shah, Aseem Srivastava +2Clinical Language Model EvaluationLLM Evaluation